Patients warned not to stop ARVs after woman suffers enlarged breasts

HIV clinicians have urged patients on antiretroviral therapy not to stop taking the life-prolonging drugs.

This comes after media reports about a woman whose breasts enlarged abnormally after taking ARVs.

Dr Francesca Conradie, president of the Clinicians Society, said: “Lipodystrophy or change in fat distribution in the body is a well-known side effect that is associated with ARVs.”

However, it was not common, she said.

Last week the Sowetan newspaper published a story of a 29-year-old woman whose breasts had overgrown.

She was diagnosed with lipohypertrophy.

She blamed her condition on the ARVs she began taking in 2006.

However, Professor Francois Venter, former president of the Clinicians Society, blamed her condition on the lack of attention by healthcare staff.

“It should never, ever get this severe,” he said.

“This condition presented in the case of people on ARVs. If slight breast enlargement is noticed, the patient should bring it to the attention of a healthcare worker, and the (specific) drug should be stopped,” Venter said.

Dr Sindi van Zyl, a general pracitioner from Johannesburg, agreed.

“Doctors and nurses that are trained in HIV management should know which early signs to look out for.

“When these signs are picked up we try to switch the patient to a better drug,” Van Zyl said.

The ARV drugs that have been found to be linked to lipohypertrophy are efavirenz and stavudine. Stavudine was phased out in April 2010 as one of the drugs prescribed to adults starting with treatment.

However, efavirenz was introduced at the same time.

Venter said it should be noted that while efavirenz is associated with lipohypertrophy, “it is still a fantastic drug.”

“But, like all drugs, it has some side effects. If you get breast enlargement, simply switching it quickly will do the trick,” he said.

Conradie shared the same sentiments but also warned that certain reasons such as previous resistance or TB infection may mean a patient cannot switch to other drugs.

Both Conradie and Venter advised people on HIV treatment to continue taking ARVs.

“This is a known side effect and this extent is very uncommon,” said Conradie.

While Venter said: “If anything is worrying you, bring it to the attention of the health worker.

“In almost all cases, we should be able to help – if you are dissatisfied, try someone else,” he said.

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